Abstract

Atrial fibrillation
occurring after cardiac surgery has been the subject of intensive research over
the past decades. However, the incidence remains high, despite numerous preventive
and treatment strategies. In addition, several reports show that the impact of
post-operative atrial fibrillation (POAF) is high. It is an independent risk
factor for mortality after several years. These findings make clear that the
fact that the pathophysiology of POAF is not fully understood and POAF-associated
risks to some extent might be underestimated. On the one hand, excessive
triggers during the acute post operative phase after cardiac surgery might initiate
AF even in atria with low vulnerability. On the other hand, many patients
undergoing surgery have an atrial substrate at the time of operation promoting
AF not only in the post-operative phase but also in the days and weeks
thereafter. Progress in our understanding of the AF mechanisms in general has provided
valuable insights into processes involved in atrial structural remodeling due
to advanced age, hypertension, obesity, and congestive heart failure. These
patient characteristics strongly contribute to cardiac disease, predict POAF
and likely have an impact on the risk of thrombus formation in the weeks and
months after cardiac surgery. For a better understanding of the mechanisms
involved, it is important to not only recognize the occurrence of POAF by
continuous monitoring after surgery, but also to identity the extent of atrial vulnerability
to AF in these patients.

Credits: E Bidar; S Bramer; B Maesen; J G Maessen; U Schotten

Dr. Andrea Natale

Dr. Andrea Natale is a board certified electrophysiology expert and practices at executive medical director of the Texas Cardiac Arrhythmia Institute at St. David's Medical Center in Austin, Texas. Dr. Natale also is the Senior Medical Director at Pacific Atrial Fib and Arrhythmia Center in San Francisco. He visits MetroHealth in Cleveland, and Akron General, Ohio. He has pioneered a new circumferential ultrasound vein-ablation system to correct atrial fibrillation and performed the procedure on the world's first five patients. For further details Please visit :Link

Dr. Dhanunjaya Lakkireddy

Dr. Dhanunjaya Lakkireddy, MD, F.A.C.C, FHRS. is a board certified electrophysiology expert and practices at Mid-America Cardiology and The University of Kansas Hospital Clinics in Kansas City, KS, USA. He has several distinctions in clinical and research career to his credit and serves as an associate editor for Journal of Atrial Fibrillation.For further details Please visit :Link